Anxiety and Substance Abuse: A Guide to Understanding the Relationship

By Rachael Rosenberg | 04/09/2019

Almost 20 percent of Americans have some type of anxiety. Along with those who have anxiety, some people have co-occurring disorders. These include substance abuse. This article aims to help you understand the relationship between anxiety and substance abuse. Which happens first: anxiety or substance abuse? What are the statistics on anxiety and substance abuse? How do you get help, and what are the treatment options available?

Anxiety and Substance Abuse

According to an article by Smith and Book published in 2008 in the journal Psychiatric Times:

Decades of research in psychiatry have shown that anxiety disorders and substance use disorders co-occur at greater rates than would be expected by chance alone. This co-occurrence, or comorbidity, between anxiety and substance use disorders has generated considerable interest among researchers and clinicians, due to its relatively high prevalence, developmental and maintenance characteristics, clinical impact, and unique treatment factors.

There are three scenarios, and each has validity when it comes to the correlation between substance abuse and anxiety.

In one scenario, a person has anxiety first, then later has a substance abuse problem. In another scenario, the person has a substance abuse problem, then anxiety issues. In the third scenario, the person has co-occurring issues and has both anxiety and substance abuse at the same time. This condition is also called a dual diagnosis.

What Are the Statistics on Anxiety and Substance Abuse?

Here are a few statistics from the aforementioned study published in Psychiatric Times:

The rates of co-occurring anxiety and substance use disorders are as follows:

Specific phobia and drug dependence: almost 4 percent

Social phobia and drug dependence: almost 5 percent

Generalized anxiety disorder and drug dependence: almost 10 percent

Panic disorder with agoraphobia and substance abuse: about 9 percent

Panic disorder without agoraphobia: about 6 percent

Any anxiety disorder and drug dependence: 6 percent

These figures show that there are three pathways to anxiety and substance abuse. The first is self-medication. The second is the substance-induced disorder pathway. And a third variable pathway can be due to things like genetics or anxiety sensitivity.

The problem is that some people who have anxiety try to dull the anxiety with alcohol or substances. Someone who has anxiety can experience the following symptoms:

Restlessness

Fear

Difficulty breathing

Disorientation

Nausea or vomiting

Pervasive dread

Hypervigilance

Insomnia

Rapid heartbeat

Tense muscles

Fatigue

Inability to socialize

People with anxiety may want to experience a feeling of euphoria that counterbalances the symptoms of anxiety. The problem is that this good feeling does not last long. The dopamine gets reabsorbed once the body breaks down the substances. Now that person needs to self-medicate again just to experience the same feeling. This is a cycle that leads to more substance abuse to feel the same feelings, which increases the tolerance level.

Psychology Today calls it a “cycle of self-medication and rebound anxiety.” This is a process of deepening both the addiction and the symptoms of anxiety disorder. In a vicious form of catch-22, the same drugs that bring momentary relief (whether prescription drugs, illegal drugs, or simply caffeine) can also cause anxiety.

What Kind of Treatment Is Available?

The American Psychological Association explains that licensed psychologists use therapies including cognitive behavioral therapy (or CBT) to help their clients identify and learn from the sources of their anxiety. Therapy helps clients make strides towards restoring a sense of balance and stable mental health to their lives. Simply walking away from treatment after detox is ineffective. And doing so might even prove more harmful.

There are six types of anxiety disorder:

Generalized anxiety disorder

Obsessive-compulsive disorder

Social anxiety disorder

Post-traumatic stress disorder

Panic disorder

Specific disorders

Panic disorder and generalized anxiety disorder are the most common among those with substance abuse issues. Yet, this does not mean that someone cannot have a substance abuse disorder with any of the other anxiety disorders.

And when it comes to substance abuse, for some it can elevate feelings of anxiety and make things worse.

Untreated anxiety disorders can affect a person’s health in a number of detrimental ways. It can lead to high blood pressure, heart disease, and even sexual dysfunction. It’s not only unhealthy to the mind but unhealthy to the body, too.

Dual diagnosis treatment programs for anxiety disorders and substance use disorders are customized for each individual patient. But there are certain treatments that are the norm:

Detox services

Individual therapy

Group therapy

Family therapy

Coping skills classes

Holistic healing practices for effective stress management

Transitional sober-living style options

If you or someone you love is suffering from an anxiety disorder along with substance abuse issues, we can help here at Transformations Treatment Center. Feel free to contact us and let us help you or your loved one get started on the path to healing.

Our center provides options such as experiential treatment, which includes the following:

Music studio

Adventure therapy

Serenity lounge

Social interaction and recreation

There are also specialist therapies including:

Holistic therapy

Psychiatric services

EMDR (Eye Movement Desensitization and Reprocessing)

While one single treatment option is unlikely to work by itself, a combination of the right treatment options can prove successful for treating anxiety and substance abuse.